Femoral head osteonecrosis post-COVID-19 infection, a prophecy coming true. A report of seven hips.

Abstract Background: COVID-19 is relatively a new condition, the long-term effects of which have not been thoroughly studied yet. Musculoskeletal complications following COVID-19 infection or because of its medications used had been reported in the literature. Here, we report on seven hips in four patients who presented with osteonecrosis of the femoral head (ONFH) after having COVID-19 infection and their treatment regimen included glucocorticoid. Cases presentation: Four patients presented to us complaining of hip pain (bilateral in three patients and unilateral in one), all reported being diagnosed as having COVID-19 infection, and their line of management included corticosteroids intake for various durations. The diagnosis was confirmed by plain hip radiographs and magnetic resonance imaging. The disease was in the early stages in all patients without femoral head collapse. Thus, all hips were treated by core decompression. Conclusion: ONFH is a real concern in patients who had COVID-19 infection, especially when corticosteroids were administered as part of their management. A follow-up and screening strategy should be established for patients who had COVID-19 infection to detect early development of hip osteonecrosis.